“Family involvement should be part of a specific treatment plan rather than informal and as needed. Families should be actively approached and engaged as early as possible.”Early Psychosis: A Care Guide

“Meaningful involvement of…family members is a fundamental component of mental health reform.”Accountability and Performance Indicators for Mental Health Services and Supports, Kimberley McEwan PhD and Elliot Goldner MD, prepared for the Federal/Provincial/Territorial Advisory Network on Mental Health

Families can play a crucial role in the treatment process and in helping their ill relatives get better, and stay better, although this isn’t always recognized by professionals. Pathways advocates for family involvement and explains to family members how to ensure that their participation will be accepted.

It wasn’t so long ago that families, particular mothers, were blamed for causing their relatives’ illness – they didn’t bring them up properly; the mother was too controlling or, the opposite, too passive and effeminate; the father wasn’t assertive enough or, the opposite, he was too assertive and dominating; you name it… Family members, accordingly, were kept at a distance by many professionals and often completely shut out. That myth of parent causation of the illness fortunately has been laid to rest, as the biological causes of serious mental illnesses like schizophrenia and bipolar disorder have been better understood.

This didn’t end the problems, however. If family members were no longer considered responsible for their relatives’ illness, they were still largely considered irrelevant to the treatment process or, worse, an interfering nuisance, best kept out of the way. They didn’t have professional training, it was argued. Any observations and information they had were discounted.

This has all changed now, or is in the process of change, as Pathways SMIS and similar family-governed organizations across Canada and elsewhere have made the case for families being part of the treatment team. The key role of family involvement in the treatment process is now recognized in both the clinical literature and best-practices documentation.

Clinical findings confirm that when family and friends are involved and are educated about the illness, and when professionals take them into their confidence, outcomes for patients are significantly better, there are fewer subsequent psychotic breaks and returns to hospital, and the health system accordingly saves money because of less use of intensive hospital care. Best-practices literature, similarly, rates “family self-help organizations” as a core element of an optimum health-care system and calls for their funding as a basic requirement. Family involvement in treatment decisions and planning are similarly recognized as fundamental components.

Advocating for family involvement in the treatment process is one of Pathways’s most important functions.

Useful references

Why is family involvement important?
A detailed explanation of just how important family involvement is in the treatment and management of serious mental illness.

Family Involvement with Mental Illness and Addiction Services
Vancouver Coastal Health, 2014

Family as a theraputic partner
An excerpt from Early Psychosis: A Care Guide, Mental Health Evaluation & Community Consultation Unit (MHECCU).

The clinical literature
A bibliography of the clinical literature on family involvement in the treatment of mental illness.